Definition This is a condition of peripheral nerves in which there is damage to and a decrease in the function of the affected nerves. Damage to the nerves may result in decreased sensation, decreased ability to move, or numbness, or both. There may also be positive symptoms such as pins and needles, tingling or burning.

What is going on in the body? This form of peripheral neuropathy is not a disease itself, but rather a result of several different disease processes.

A peripheral neuropathy involves the nerves that branch from the brain and spinal cord, which are called peripheral nerves. Damage is usually caused by a loss of myelin on these peripheral nerves. Myelin is a protective covering that increases the speed at which information can be sent through a nerve. In addition, direct trauma to a nerve can block information from passing through the nerve at any point at which there is damage. The axon or inner part of the nerve can also be damaged.

What are the signs and symptoms of the condition? The signs and symptoms may include:

weakness

difficulty walking

difficulty swallowing

hoarseness

a burning sensation

decreased or absent sensation, usually involving the hands or feet

cuts or burns that are not noticed or felt at the time of injury

pins, needles, tingling

What are the causes and risks of the condition? Peripheral neuropathy is usually associated with other conditions such as diabetic neuropathy due to diabetes mellitus, Guillain-Barre syndrome, and the use of some medications. It can also be caused by pressure on the nerves, inflammation, decreased blood flow, or other autoimmune disorders, and nutritional or vitamin deficiencies.

What can be done to prevent the condition? Prevention is based upon treating the individual cause.

How is the condition diagnosed? The diagnosis is made by examination, with consideration of the individual's disease process. In many individuals there will be weakness, decreased sensation, and possibly even muscle shrinkage, known as atrophy. Tests that can be done include electromyography, or EMG, which is designed to examine the electrical activity of the involved muscles, and nerve conduction studies (NCS) that test for damage of the peripheral nerves. Other possible tests include X-rays and blood tests and biopsy or surgical sampling of a nerve.

What are the long-term effects of the condition? Individuals with a sensorimotor polyneuropathy may notice that they are having increasing difficulty feeling injuries. They may have difficulty moving muscles and there may be associated pain. This pain can actually be worse at night when a person is not moving and last for long periods of time. Occasionally, peripheral neuropathy can be severe and life threatening.

What are the risks to others? This is not a communicable disease, or disease that can be transmitted from one individual to another.

What are the treatments for the condition? The treatments are varied, depending upon the underlying problem. Examples include:

control of blood sugars for diabetics

abstinence from alcohol, which can cause peripheral neuropathy

decreasing smoking, which can clog the arteries that supply blood to peripheral nerves and cause a neuropathy

physiotherapy and occupational therapy if needed

replacement of vitamin deficiencies such as vitamin B12

Some medications can help decrease the pain associated with sensorimotor polyneuropathies, including over-the-counter analgesics, narcotics, and tricyclic antidepressants, such as amitriptyline or nortriptyline. Also, safety measures may be needed because of an increased risk of falls. Frequent examination of any areas that are affected by neuropathy will help make sure that there are not sores, ulcers, or other abnormalities occurring that cannot be felt.

What are the side effects of the treatments? Any treatment has potential side effects. The medications mentioned may cause stomach, kidney and liver problems as well as increase the risk of falling, by making individuals more sleepy. These medications can also cause dry mouth and constipation.

What happens after treatment for the condition? After damage to peripheral nerves, complications are fairly frequent, even with adequate, ongoing treatment. These include complete loss of motion, complete loss of sensation, and injuries to the areas supplied by the damaged nerves. Because injuries to these areas are often not sensed, development of tissue infection and tissue death, or necrosis, may occur.

How is the condition monitored? Peripheral neuropathy must be monitored by doctor and patient alike. Patients must report increasing loss of movement or sensation, any trauma to the affected area and medication side effects to their doctors. The doctor will also monitor the neuropathy and any medications to maximise effectiveness, while trying to minimise side effects.

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